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Penile Vibratory Stimulation; The Method of Choice for Anejaculation After Spinal Cord Injury

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Dr. Ibrahim will be presenting at the American Urological Association Annual Meeting on Sunday April 30, 2023 from 3:30 PM to 5:30 PM.

What are the highlights that attendees should take away from your presentation?

Spinal cord injury (SCI) is the leading cause of anejaculation in young men. After SCI 90% of these men will need a method of assisted ejaculation to achieve biological fatherhood. Penile vibratory stimulation (PVS) was popularized in 1994 after the production of the first vibrator specifically designed for semen retrieval men with SCI. This video presentation will teach attendees new skills and techniques on performing PVS to treat ejaculatory dysfunction in men SCI. 

What is the central question that your study and/or presentation tries to answer?

This presentation covers the gap in current knowledge regarding treatment of anejaculation in men with SCI and shows urologist and providers a simple method that is successful in 86% of men suffering from this injury. When any able-bodied man seeks medical assistance regarding infertility, the first step is ordering a simple semen analysis. Unfortunately, and due to the lack of knowledge, when men with SCI see the same providers, they are told the only option is surgical sperm retrieval which commits the couple to the most expensive ART method of IVF/ICSI due to the low recovered sperm numbers.

If applicable, what are the key findings from your study?

PVS was successful in 86% of men whose level of injury was T10 or rostral. A total of 3,698 PVS procedures were successfully performed by the Male Fertility Program at the Miami Project to Cure Paralysis in University of Miami. The total motile sperm count in antegrade ejaculates produced by PVS was >5 million (lower limit considered for IUI) in 71% of ejaculates. This study will avoid the need to perform surgical sperm extraction and allow the treating provider to have full data about the sperm quality using the simple method of PVS in the office. These findings might change the management from the invasive and expensive IVF/ICSI to Intrauterine insemination (IUI) and may be the most natural method of home insemination in some select cases. 

How do these findings and/or conclusions potentially impact clinical practice?

The application of this technique can dramatically change the clinical practice and management of couples with a disabled male partner and minimize the risk and cost of advanced assisted reproductive techniques.

What else would you like attendees to know about your presentation?

Attendees will learn how to safely perform the PVS procedure. How to manage autonomic dysreflexia which occurs in all men with SCI presenting with a neurological level of injury at T6 or rostral. Attendees will also learn how to prepare the patient and collect retrograde ejaculation specimens. By having this relatively cheap medical vibrator and having it in a clinic, providers will be able to assist 86% of men with SCI who seek treatment to their ejaculatory dysfunction and infertility.

Session details: Video-V11 / Sexual Dysfunction/ Infertility / Andrology

Abstract ID: 23-2927

Dr. Ibrahim has no conflicts of interest to report.

Image by Denis Novikov / Getty

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